Health care should be a birthright

As the nation marks the 50th anniversary of Medicare the discussion of expanding the program and offering universal health care is resurfacing.

It's not a new debate. Fifty years before Medicare's enactment, progressives had fought unsuccessfully for universal, government-provided health insurance, wrote Nancy Altman, founding co-director of Social Security Works, for the Huffington Post.

In 1912, President Theodore Roosevelt's Progressive Party platform advocated universal, government-sponsored, health insurance, but he was defeated in his re-election bid. In 1917, the California legislature approved universal health insurance, and the governor supported it, but it was defeated in a ballot resolution after a massive, well-financed business and physician-fueled campaign against it. President Franklin Roosevelt considered including national health insurance in his 1935 Social Security legislation, but decided against it out of fear that it would bring down the entire legislative package. President Harry Truman made universal health insurance a top priority, but got nowhere.

So progressives settled on first creating Medicare for seniors, with the goal of expanding coverage to other groups incrementally and ultimately offering universal coverage.

"Universal, government-sponsored insurance is the most effective and efficient way to cover everyone," Altman wrote. "Insurance is least expensive when it covers the most people; the large size of government-sponsored health insurance provides economies of scale and the greatest ability to negotiate over prices and control costs. Moreover, unlike private health insurance, a government plan has no marketing costs and no high CEO salaries. It can provide health care less expensively and more efficiently for everyone."

Compared to Medicare's administrative costs of just 1.4 percent, the administrative costs of private health insurance by very small firms or purchased by individuals can run as high as 30 percent, Altman notes. Even for large companies the administrative costs run around 7 percent.

Unfortunately, politicking and heavy lobbying by the insurance industry over the years waylaid those efforts to expand Medicare. But there are still some pushing for real health care reform — not the Affordable Care Act version that still involves profit-motivated companies and isn't quite so affordable for everyone.

Addressing a rally outside the Capitol to mark the 50th anniversary of Medicare on Thursday, presidential contender and U.S. Sen. Bernie Sanders, I-Vt., said he will introduce legislation to provide Medicare-for-all health insurance.

He said providing health insurance for all Americans would result in better care, improved access and lower costs by eliminating the middle-man role played by insurance companies that now rake in billions of dollars in profits. Sanders' bill would set federal guidelines and strong minimum standards for states to administer single-payer health care programs.

"The United States is the only major nation in the industrialized world that does not guarantee health care as a right to its people," Sanders said. "Meanwhile, we spend far more per capita on health care with worse results than other countries."

As Sanders noted, thousands of people die each year in the U.S. because they delay seeking care they cannot afford. Health care eats up one-fifth of our economy, but the U.S. ranks 27th among major, developed nations on life expectancy and 31st on infant mortality.

Sanders said his proposal also would rein in skyrocketing prices for prescription drugs. Americans pay pharmaceutical companies nearly twice for the exact same drugs manufactured by the exact same companies in other countries.

"This is unacceptable," Sanders said. "Until we put patients over profits, our system will not work for ordinary Americans."

In contrast to Sanders, GOP contenders are calling for the phasing out of Medicare.

As Altman wrote, "This upcoming presidential election could be a powerful defining moment. If each Party's platform reflects these views, the American people will have a clear choice. ... If we follow the lead of those visionary architects fifty years ago, those who come after us will inherit a nation where affordable, first class health insurance — Medicare for All — is a birthright."